Individual provider Active NPI

Carmen Marie Macmillan, LPC

  • Professional Counselor
  • Eugene, OR
National Provider Identifier
1174853386
Registry record updated Feb 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
C5822 Issued in OR
Practice address
66 Club Rd Ste 120
Eugene, OR 97401-2439
Phone
(541) 393-5983
Fax
(541) 393-5984
NPI assigned
Jan 11, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Professional Counselor 101YP2500X C5822 OR Primary

Addresses

Primary practice location

66 Club Rd Ste 120
Eugene, OR 97401-2439

Mailing address

66 Club Rd Ste 160
Eugene, OR 97401-2439
Phone (541) 345-1722

Other identifiers 2

IdentifierTypeStateIssuer
15091907OtherCAQH ID
500661183MedicaidOR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240216002250 OR Practitioner - Mental Health Counselor 9537503651 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Amber Benson Pmhnp PCGroup PAC ID 3072786755, 24 clinicians

Practice addresses (Care Compare)

66 Club Rd
Suite 160
Eugene, OR 97401-2439
Phone (541) 345-1722

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Practice roles

OrganizationSpecialtyStatusNew patients
Amber Benson Pmhnp PC CurrentSince Jan 2, 2024 Accepting new patients

Locations

66 Club Rd
Ste 160
Eugene, OR 97401
Phone (541) 345-1722

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1263168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708560000000",
    "number": "1174853386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "66 CLUB RD STE 160",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974012439",
            "telephone_number": "541-345-1722",
            "fax_number": "541-485-7049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "66 CLUB RD STE 120",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974012439",
            "telephone_number": "541-393-5983",
            "fax_number": "541-393-5984"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACMILLAN",
        "first_name": "CARMEN",
        "middle_name": "MARIE",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-01-11",
        "last_updated": "2024-02-22",
        "certification_date": "2024-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OR",
            "license": "C5822",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH ID",
            "identifier": "15091907",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500661183",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Eugene, OR

Sources for this page

Verify at the official NPI Registry.